Healthcare professionals' attitudes toward cancer precision medicine: A systematic review

J Vetsch; C E Wakefield; P Techakesari; M Warby; D S Ziegler; T A O'Brien; C Drinkwater; N Neeman; K Tucker

doi:10.1053/j.seminoncol.2019.05.001

Healthcare professionals' attitudes toward cancer precision medicine: A systematic review

Semin Oncol. 2019 Jun;46(3):291-303. doi: 10.1053/j.seminoncol.2019.05.001. Epub 2019 Jun 10.

Authors

J Vetsch¹, C E Wakefield², P Techakesari¹, M Warby³, D S Ziegler¹, T A O'Brien¹, C Drinkwater⁴, N Neeman⁴, K Tucker⁵

Affiliations

¹ School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.
² School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia. Electronic address: c.wakefield@unsw.edu.au.
³ Hereditary Cancer Centre, Department of Oncology and Haematology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
⁴ Hudson Institute of Medical Research, Clayton, Victoria, Australia.
⁵ Hereditary Cancer Centre, Department of Oncology and Haematology, Prince of Wales Hospital, Randwick, New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 31221444
DOI: 10.1053/j.seminoncol.2019.05.001

Abstract

Use of precision medicine in oncology is burgeoning and can provide patients with new treatment options. However, it is not clear how precision medicine is impacting healthcare professionals (HCPs), particularly with regards to their concerns about this new approach. We therefore synthesized the existing literature on HCPs' attitudes toward cancer precision medicine. We searched four databases for relevant articles. Two reviewers screened eligible articles and extracted data. We assessed the quality of each article using the QualSyst tool. We found 22 articles, representing 4,321 HCPs (63.7% cancer specialists). HCPs held largely positive attitudes toward cancer precision medicine, including their capacity to facilitate treatment decisions and provide prognostic information. However, they also had concerns regarding costs, insurance coverage, limited HCP knowledge about precision medicine, potential misuse, difficulties accessing the tests, and delays in receiving test results. Most HCPs felt that test-related decisions should be shared between families and HCPs. HCPs intended to disclose actionable results but were less inclined to disclose negative/secondary findings. HCPs had a strong preference for genetic counselor involvement when disclosing germline findings. Most HCPs intended to use somatic and germline tests in their future practice but the extent to which pharmacogenomic tests will be used is uncertain. HCPs indicated that additional evidence supporting test utility and increased availability of treatment guidelines could facilitate the use of testing. HCPs held generally positive attitudes toward cancer precision medicine, however there were some key concerns. Addressing concerns early, devising educational support for HCPs and developing guidelines may facilitate the successful implementation of precision medicine trials in the future.

Keywords: Genomic testing; Oncology; Personalized medicine; Precision cancer medicine; Precision medicine; Precision oncology; Psychosocial; Systematic review.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Attitude of Health Personnel*
Germ-Line Mutation / genetics
Humans
Neoplasms / epidemiology*
Neoplasms / genetics
Precision Medicine*
Prognosis